The European Stroke Agency (ESO) guidance on the management of mobile ischemic attack focuses on issues specific to the early management of TIA. Thus, areas such as organization of services include the role of stroke specialists and TIA clinics; the usefulness of risk prediction tools such as the ABCD2 score; Brain imaging (plain and perfusion CT, MRI), images of cervical artery, and single and double antiplatelet are covered.
Intractable ischemic attack or TIA (also known as minor stroke) is similar to a stroke, except that the symptoms last for a short time. TIA can be a warning for a more dangerous and potentially fatal stroke and is a common reason why people seek medical care. Recognition of the importance of TIAs allows for prompt specialist treatment, which may include the administration of medications to reduce the risk of subsequent stroke.
For some people at high risk for stroke, and who do not have the TIA due to a heart problem take two combined medications such as tablets (Aspirin and clopidogrel), within the first day after a TIA and for up to 3 weeks later, they can reduce the risk of stroke.
For every 50 ‘at risk’ patients treated in this way, one patient avoids recurrent stroke.
For someone who has received a TIA, it is recommended that they have a specialist review at a TIA clinic within the first day of the TIA, rather than waiting more than a day for a regular outpatient appointment. .
Healthcare professionals sometimes use simple equations, called risk prediction tools, to help them assess who is most at risk of subsequent stroke. However, these prediction tools should not be the only way in which risk is assessed. TIA is a clinical diagnosis and calculated predictive scores should not replace clinical assessment where diagnosis is made by an experienced specialist healthcare professional.
Brain scans using a specialist CT or MRI scanner may help confirm that temporary neurological symptoms are the result of a TIA. These specialized scans are thought to be more useful than a standard CT brain scan, but it may not always be possible to perform these advanced scans everywhere.
When diagnosing a TIA, it is important to try to see if there is a narrowing of some large blood vessels in the brain. Blood tests performed in conjunction with a brain scanner eg MRA (MRI-based blood vessel test) or CTA (CT-based blood vessel test also known as angiogram) should be present to help detect any narrowing and to determine the best course. of treatment.
It is not yet known what is the best health care setting for TIA treatment. Major research studies are needed to compare the treatment of TIA in for example a TIA clinic, or on a stroke unit, or in an emergency department etc, to see which one is most useful and cost effective to prevent on a stroke.
These recommendations aim to emphasize prompt acute evaluation and relevant secondary prevention.
Source:
European Stroke Association (ESO)